The NHS’s commitment to a sustainable future: ‘net-zero’ and the role of technology, innovation and people

Date published




In its report ‘Delivering a ‘Net Zero’ National Health Service’ published on 1 October 2020, the NHS made the historic commitment to reduce its greenhouse gas emissions to net-zero by 2040 - the first national health service in the world to set such a goal – and set out its approach. This will require a major transformation: from the way the NHS provides care, to the types of medicines used and its supply chains, to how the NHS estate and supporting facilities services are managed.

The NHS is the United Kingdom’s largest employer, with a workforce of more than 1.3 million people and as such (and as set out in the report) is responsible for approximately 4% of the UK’s carbon footprint. The report further notes that if the UK is to succeed in its overarching climate change goals – the UK was the first major economy to pass a commitment to reach net zero emissions by 2050 into law - then the NHS must be a significant part of the solution.

It is hoped actions taken by the NHS will be mutually beneficial for the environment and the well-being and health of its staff and patients. In the provision of healthcare services this will include the increased use of ‘social prescribing’; encouraging medical professionals to place more emphasis on non-clinical services including physical activity such as walking and gardening that bring environmental co-benefits (including reduced waste from prescription drugs).

In the NHS’s wider operations this will include encouraging cleaner forms of travel to improve air quality - and enhancing the health of staff and patients by encouraging walking and cycling.


COVID-19 has had a profound impact on the NHS and has caused an unparalleled shift in the way the NHS provides its services.  

The necessary proliferation of single-use Personal Protective Equipment (PPE) has been unprecedented. Significantly more PPE waste has been generated than during business-as-usual operations, of which a large proportion requires incineration due to its infectious nature. It is hoped that through innovation, the NHS will create effective alternatives to PPE which get the balance right between re-usability and infection control.

There has also been an increase in the use of environmentally problematic prescriptions such as inhalers. The NHS hope changes such as switching to dry powder inhalers, reducing volatile anaesthetic gas and recycling will mitigate the negative environmental impacts of this type of product. Of note, research also suggests that up to one-third of asthma cases might be avoided as a result of efforts to cut emissions.

There are many positives to be drawn from the NHS’s COVID-19 response. The pandemic has demonstrated the NHS’s impressive ability to adapt, as well as its resilience – both of which will undoubtedly continue to be necessary for the NHS in relation to achieving its net-zero emissions goal.

The roll out of digitised primary and secondary care at scale is but one example of this ability to adapt.  Previously anticipated as taking many years to instigate, the NHS made it possible in a matter of weeks. Such digitised care will play an important role in the NHS achieving its net-zero goal.  


Whilst cutting edge technology and innovation will play a key role in supporting the NHS in its aim of reaching ‘net-zero’, the everyday actions of the NHS’s 1.3 million staff and millions more patients will also be critical to achieving this goal. Sustainability will need to be integrated into the culture and fabric of the NHS so that the NHS’s core activities deliver for both people and planet.

Read others items in Healthcare Brief - December 2020